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NPI 1356093157

NPI 1356093157 : SANDRA DURHAM MASTERS MFT : NASHVILLE, TN

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General NPI Number Information
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    NPI Number           |    1356093157
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    Entity Type          |    Individual 
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    Provider Name        |    SANDRA DURHAM MASTERS MFT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    01/23/2022
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    Last Update Date     |    01/23/2022
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Provider Practice Location Address
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    Address Line         |    805 WOODLAND ST UNIT 340 
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    City                 |    NASHVILLE
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    State                |    TN
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    Zip                  |    37206-3765
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    Country              |    US
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    Telephone            |    615-477-1475
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    4636 LEBANON PIKE 
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    City                 |    HERMITAGE
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    State                |    TN
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    Zip                  |    37076-1316
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    Country              |    US
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    Telephone            |    615-606-3847
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    106H00000X
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    Taxonomy Name        |    Marriage & Family Therapist
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    License Number       |    
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    License Number State |    
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